Lee Yeongjoo, Jang Jaehyuk, Lim Sungmin, Na Sae Jung
Division of Nuclear, Medicine Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 11765, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 11765, Republic of Korea.
Diagnostics (Basel). 2024 Aug 6;14(16):1705. doi: 10.3390/diagnostics14161705.
Cardiac 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography (FDG PET) is widely used to assess myocardial viability in patients with ischemic heart disease. While sufficient glucose uptake is a prerequisite for accurate interpretation of cardiac viability, there are a lack of data on which clinical variables have the most significant impact on myocardial glucose metabolism. Therefore, this study was designed to evaluate several clinical variables that could affect myocardial glucose metabolism.
A total of 214 consecutive cases were retrospectively enrolled in this study. All subjects received 250 mg of acipimox and underwent glucose loading as preparation for cardiac FDG PET/CT. Three-dimensional regions of interest (ROIs) were drawn on PET/CT fusion images. Myocardial glucose uptake ratio (MGUR = SUVmax of LV myocardium/SUVmean of liver) was then calculated. Multiple clinical variables including body mass index (BMI), blood glucose levels at different times, administered insulin dosage, lipid profiles, and ejection fraction were measured and analyzed for correlation with myocardial glucose uptake. After dichotomizing the subjects based on a BMI of 25, each group's MGUR was compared.
Myocardial uptake showed significant correlations with BMI (r = -0.162, = 0.018), HbA1c (r = -0.150, = 0.030), and triglyceride levels (r = -0.137, = 0.046). No other clinical variables showed a significant correlation with myocardial glucose uptake. After multiple linear regression analysis, BMI ( = 0.032) and HbA1c ( = 0.050) showed a correlation with MGUR. In group analysis, after dividing patients based on BMI, the obese group showed significantly lower myocardial uptake than the non-obese group (3.8 ± 1.9 vs. 4.4 ± 2.1, = 0.031).
Among several clinical variables, BMI and HbA1c levels were related to myocardial glucose uptake. A prospective study would be needed to examine whether a protocol that additionally considers BMI and HbA1c levels is necessary for the current cardiac FDG PET protocol.
心脏2-脱氧-2-[F-18]氟-D-葡萄糖正电子发射断层扫描（FDG PET）广泛用于评估缺血性心脏病患者的心肌活力。虽然足够的葡萄糖摄取是准确解读心脏活力的先决条件，但关于哪些临床变量对心肌葡萄糖代谢影响最大的数据却很缺乏。因此，本研究旨在评估几个可能影响心肌葡萄糖代谢的临床变量。
本研究回顾性纳入了连续的214例病例。所有受试者均接受250mg阿昔莫司并进行葡萄糖负荷，以准备心脏FDG PET/CT检查。在PET/CT融合图像上绘制三维感兴趣区（ROI）。然后计算心肌葡萄糖摄取率（MGUR = 左心室心肌SUVmax/肝脏SUVmean）。测量并分析包括体重指数（BMI）、不同时间的血糖水平、胰岛素给药剂量、血脂谱和射血分数在内的多个临床变量与心肌葡萄糖摄取的相关性。根据BMI为25对受试者进行二分法分组后，比较每组的MGUR。
心肌摄取与BMI（r = -0.162，P = 0.018）、糖化血红蛋白（HbA1c）（r = -0.150，P = 0.030）和甘油三酯水平（r = -0.137，P = 0.046）显著相关。没有其他临床变量与心肌葡萄糖摄取显示出显著相关性。经过多元线性回归分析，BMI（P = 0.032）和HbA1c（P = 0.050）与MGUR相关。在分组分析中，根据BMI对患者进行分组后，肥胖组的心肌摄取显著低于非肥胖组（3.8±1.9 vs. 4.4±2.1，P = 0.031）。
在几个临床变量中，BMI和HbA1c水平与心肌葡萄糖摄取有关。需要进行前瞻性研究，以检验当前心脏FDG PET方案是否需要额外考虑BMI和HbA1c水平的方案。
